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TABLE I -CHECKLIST 4F REOUIRED DATA <br /> FOR NO FARTHER ACTION REQUESTS AT UNDERGROUND TANK SITES <br /> 1 <br /> ifs d�lante and Location. £ 5 <br /> t, yes lis=c a to production wells for municipal, domestic, :agneAlure, industry and other uses ,sriithin 2000 <br /> feet of the site, <br /> ' 2. y tis Site nu", to stele, of area impacted showing locations of fomw and existing tank systems. <br /> excavation m1'Ymoum and sample locations, hwbV and monitoring well elevatkm tongs, gradients, <br /> and nearby surface waters, Wildings, streets, aM subsusfoo r utliities; <br /> ' 3. )�js Figon depicting litlrolregy (cms section),tivatment systema diagrams; <br /> 4. Na Stockoed soil remailning tura-site or aft-silo desposal (quanlity); <br /> S. mL Mordtoring wells remaining on-she, fate; <br /> 6. N f l� Tabulated results of eteryatllons and des to wets <br /> 7, y�„s TatnArted rasutls of aN samoing and an* : <br /> Detection limits for confirrmafjon sampling <br /> Leads analyses <br /> 8, ye 5 Concentrations oontows,of contaminants found and those remaining in soil and groundwater, both on- <br /> site and <br /> n- <br /> s te'and off-site. <br /> ye,,, LaterW exienrt of soil contamination <br /> y v-S Vertical extent of soil contandnation <br /> ' ,sly Lateral extent of groundwater conlami naition <br /> N�k Vertical extent of 1;roundwaler contamination <br /> NJA Zane of Inguence calculated and assumptions used for subsurface reffwiiafiort syslem and the zonae <br /> of capture attained foT the snail and groundwater rorWAWion system: <br /> 10Reports I infowtatiOn <br /> yGs Utauthorized Release Form (URF) <br /> ' QMRs (Dates) <br /> yds <br /> PAR <br /> PP <br /> ' ycs tither(report rwm) c- s� <br /> Well and boring logs <br /> ' 11. Off. Best Available Technology(83 kT) used or an explanation for not using BAT; <br /> 9 z >J,[i Reams why " aclrground*wa3fts anal lain to using ELAT; <br /> 13.tfA Mass balance calculation of substance treated versus that roma ming; <br /> ' 14,R/..A Assumptions, parameters,calculations and model used,in risk assessments, and fajta and transpWl <br /> modeliirsg; <br /> 15.:XL-"> 'RationaW why conditions rernaiatirag at site w gl not adversely-impact water quality, health, or other <br /> tbeneficial uses: and <br /> VVET or TCL:P results <br /> ' Comments; <br /> BY: <br /> ' Date, <br /> f . <br />